CLINICAL CORE PROJECT SUMMARY/ABSTRACT The Clinical Core is the central component of the P30 Alzheimer?s Disease Research Center (ADRC). The Clinical Core mandate is to provide resources to further the goals of the Center in understanding biological pathways of Alzheimer?s Disease. The Core is a shared resource interacting closely with: the Outreach, Recruitment, and Engagement Core (ORE) Core with regard to recruitment and training; the Database Management and Statistical (DMS) Core with respect to data entry, storage and management; the Neuropathology Core, through arranging brain autopsy and providing relevant correlative clinical data; and the Biomarker, Genetics, and Neuroimmunology Cores through provision of DNA, plasma, blood cells, and cerebrospinal fluid samples for biomarker, genetic, and immunological analyses. The Core will build upon its 29 years as a funded P50 ADRC, during which time it has enrolled more than 6,000 individuals, nearly 1,900 of which are in the NACC Uniform Data Set (UDS) ? with ethnic diversity including about 20% Hispanics and 11% African Americans. The P30 Core will enroll 500 individuals in a new cohort: 100 new participants per year, including 25 normal controls, and 75 persons with mild cognitive impairment or dementia. These participants will each have extensive biomarker studies including research-grade 3T MRI, and lumbar puncture for cerebrospinal fluid studies, and be followed annually. The Core will provide data to the DMS Core, transmitted to the National Alzheimer?s Coordinating Center (NACC), and DNA for the Genetics Core, sent to the National Centralized Repository for Alzheimer?s Disease (NCRAD). Evaluations will include detailed medical and neurological interviews and examinations and neuropsychological testing, using NACC and Columbia site- specific instruments. Biomarkers will flow to Biomarker, Genetics, and Neuroimmunology Cores, including blood samples for plasma and peripheral blood cell populations, DNA preparation for genetic studies, CSF specimens for spinal fluid cells and fluid biomarkers, and 3T MRI neuroimaging. The Clinical Core goals include brain autopsies at the time of death, to provide neuropathological samples. The Core coordinates closely with Administrative, Biomarkers, DMS, ORE, Genetics, Neuroimmunology, and Neuropathology Cores, and with the REC module. Participants in the Core are informed of other trials and projects, and encouraged to participate in these important imaging, instrument, drug study, and biomarker trials. The Clinical Core provides training to students, residents, fellows, and investigators. Coded participant data, images, and biological specimens, including plasma, DNA, CSF, and brain tissue are shared with ADRC, and other Columbia and extramural investigators to improve diagnosis, understanding and treatment of aging and dementia, promoting basic and translational research at Columbia, in the New York area, nationwide, and internationally.